18-38 Siddeley Street
MELBOURNE VIC 3005
+61 3 9349 7813
A.B.N. 31 081 163 519
ApplicantFull Name:
Address:
PAYMENT DETAILS
The PESCI assessment fee:
An assessment fee of AUD $2,020.00 (GST Inc.) is payable on submission of your application.
Please note: aRescheduling, Cancellation, and Fee Refund policy applies.
Please refer to ourPolicy at:
Payment Method
Electronic Fund Transfer (EFT):
Please include your full name as the reference and email a copy of your EFT receipt to proof of payment.
BSB No: / 033 054
Account No: / 16-8408
Bank: / Westpac Banking Corporation
Credit Card:
Please debit my Credit Card for the amount of AUD $2,020.00.
Card Number: / 0000 - 0000 - 0000 - 0000
Expiry Date: / 00 / 00
Name on Card:
Assessment Fee: / AUD $ 2,020.00
Signature:
Date of Signature:
HWAV PESCI Rescheduling, Cancellation, and Fee Refund Policy
Applicants may cancel or reschedule their PESCI application by written request to the HWAV Assessment Administrator. The following administration fees will apply:
Reschedule a PESCI appointment:
If an applicant requests to reschedule a PESCI appointment within 15business days’ notice prior to the original PESCI appointment, the appointment will be cancelled and a new PESCI fee will apply
If an applicant requests to reschedule a PESCI appointment with at least 15 business days’ noticeprior to the original PESCI appointment date, an administration fee of $300.00 is applicable.
Any subsequent requests to reschedule the PESCI appointment date, the PESCI fee is non-refundable and a new PESCI fee will apply.
Cancellation of a PESCI appointment:
Where an applicant cancels/withdraws their application within 15 business days(with orwithout notice)of the PESCI appointment the PESCI fee paid is non-refundable.
Where an applicant cancels/withdraws their application with at least 15business days’ notice, a refund of 50% of the fee paid will apply.
A full refund of fees paid will be issued if HWAV is unable to provide the interview. HWAV reserves the right to charge a $300.00 administration fee in extenuating circumstances.
All applicable refunds approved in accordance with this policy will be paid within one month of the HWAV Administrator receiving a written request from the applicant. Refunds will only be issued to the person from whom payment was received.
Please note: Health Workforce Assessment Victoria accepts no responsibility for the loss of any monies in exchange rates between Australia and other countries, or for those fees and rates charged by banking institutions in relation to any payment.
Request to reschedule / Administration fee / RefundLess than 15 Business days’ notice / $2,020.00 / $0.00
More than 15 Business days’ notice / $300.00 / N/A
Subsequent request / $2,020.00 / $0.00
Request to cancel/refund / Administration fee / Refund
Less than 15 Business days’ notice / $2,020.00 / $0.00
More than 15 Business days’ notice / $1,010.00 / $1,010.00
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